When the Ebb ends the Flow begins

Riding the Ebb ended 3 days ago. Back on riding the Flow.

It started Friday night into Saturday with Night Sweats (that I'm still suffering from) and yesterday the panic train made a stop.

I have now come to the realization that this is completely hormonal. I don't have generalized anxiety disorder like i once thought and was diagnosed with. These attacks come in certain situations but are completely revolving around my menstrual cycle. They typically make a presence 1/2 way through my cycle and get progressively worse when my period arrives. My period arrived Monday and since then it's been panic city! At home, the car, in public, it doesn't matter.. it's there and it's all fired up!

The night sweats started 3 days before my period came. Waking up soaking wet in the middle of the night. I don't mean a little sweat. I mean A LOT, as though I took a shower. Being an Elite-Trainer on the Sharecare.com network, I decided to put my resources to work for me and looked to my colleagues for answers, and I found this great clip from Dr. Oz http://bit.ly/droznightsweats.

I have felt this way about this condition since 2005 when I had my first full-blown attack that put me in the emergency room. I looked up Pre-menstrual Dysphoric Disorder and the symptoms fit to the T. None of the anti-depressants the doctors put me on helped. I wasn't depressed - at least not consistently it would just be for a week or two before my period!

After reading books, articles, and everything in between they all suggested a hormone panel be done to pin point any and all ebbs and flows with marked data against how I was feeling. My regular doctor referred me to my Gyno/OBGYN and every doctor at the OBGYN office (there were 9 of them) said I'm too young to have a hormone panel, that it's anxiety disorder. No one would listen because I wasn't in the proper age category to be pre-menstrual or peri-menopausal, BUT all my symptoms revolved around my menstrual cycle. How is it that other women get these panels done, but I can't??

I have to switch to a new OBGYN because I now live way to far away from my current OBGYN. I'm hoping that this new doctor will listen to me this time. I'm tired of feeling this way, and it is clearly affecting my work, my lifestyle and everything else I have to deal with on a day to day basis.

Sometimes you need to be your own doctor; if anything to make sure you are getting the full picture of what's going on. 

I found this great article regarding PMDD, if you think you might suffer from this please consult with your doctor(s). I know I will be as everything I put in BOLD is what I suffer from. I also put an APP on my phone called iperiod; it allows you to mark EVERYTHING. This APP will come in very handy when I see the doctor.

Premenstrual dysphoric disorder
PMDD; Severe PMS

Last reviewed: December 22, 2010.

Premenstrual dysphoric disorder (PMDD) is a condition in which a woman has severe depression symptoms, irritability, and tension before menstruation. The symptoms of PMDD are more severe than those seen with premenstrual syndrome (PMS).

PMS refers to a wide range of physical or emotional symptoms that typically occur about 5 to 11 days before a woman starts her monthly menstrual cycle. The symptoms usually stop when or shortly after her period begins.
Causes, incidence, and risk factors

The causes of PMS and PMDD have not been found.

Hormone changes that occur during a woman's menstrual cycle appear to play a role.
PMDD affects between 3% and 8% of women during the years when they are having menstrual periods.

Many women with this condition have:
    Anxiety
    Major depression
    Seasonal affective disorder (SAD)

Other factors that may play a role include:
    Alcohol abuse
    Being overweight
    Drinking large amounts of caffeine
    Having a mother with a history of the disorder
    Lack of exercise

Symptoms

The symptoms of PMDD are similar to those of PMS. However, they are generally more severe and debilitating and include a least one mood-related symptom. Symptoms occur during the week just before menstrual bleeding and usually improve within a few days after the period starts.

Five or more of the following symptoms must be present to diagnose PMDD, including one mood-related symptom:
    Disinterest in daily activities and relationships
    Fatigue or low energy
    Feeling of sadness or hopelessness, possible suicidal thoughts
    Feelings of tension or anxiety
    Feeling out of control
    Food cravings or binge eating
    Mood swings marked by periods of teariness
    Panic attacks
    Persistent irritability or anger that affects other people
    Physical symptoms, such as bloating, breast tenderness, headaches, and joint or  muscle pain
    Problems sleeping
    Trouble concentrating

Signs and tests

No physical examination or lab tests can diagnose PMDD. A complete history, physical examination (including a pelvic exam), and psychiatric evaluation should be done to rule out other conditions.

Keeping a calendar or diary of symptoms can help women identify the most troublesome symptoms and the times when they are likely to occur. This information may help the health care provider diagnose PMDD and determine the best treatment.
Treatment

A healthy lifestyle is the first step to managing PMDD.
    Eat a balanced diet (with more whole grains, vegetables, fruit, and little or no salt, sugar, alcohol, and caffeine)
    Get regular aerobic exercise throughout the month to redue the severity of PMS symptoms
    Try changing your sleep habits before taking drugs for insomnia (See also: Sleeping difficulty)

Keep a diary or calendar to record:
    The type of symptoms you are having
    How severe they are
    How long they last

Antidepressants may be helpful.

The first option is usually an antidepressant known as a selective serotonin-reuptake inhibitor (SSRI). You can take SSRIs in the second part of your cycle up until your period starts, or for the whole month. Ask your doctor.

Cognitive behavioral therapy (CBT) may be used either with or instead of antidepressants. During CBT, you have about 10 visits with a mental health professional over several weeks.

Other treatments that may help include:

    Birth control pills may decrease or increase PMS symptoms, including depression
    Diuretics may be useful for women who gain a lot of weight from fluid retention
    Nutritional supplements -- such as vitamin B6, calcium, and magnesium -- may be recommended
    Other medicines (such as Depo-Lupron) suppress the ovaries and ovulation
    Pain relievers such as aspirin or ibuprofen may be prescribed for headache, backache, menstrual cramping and breast tenderness

Expectations (prognosis)

After proper diagnosis and treatment, most women with PMDD find that their symptoms go away or drop to tolerable levels.

Complications

PMDD symptoms may be severe enough to interfere with a woman's daily life. Women with depression may have worse symptoms during the second half of their cycle and may need changes in their medication.

As many as 10% of women who report PMS symptoms, especially those with PMDD, have had suicidal thoughts. Suicide in women with depression is much more likely to occur during the second half of the menstrual cycle.

PMDD may be associated with eating disorders and smoking.
Calling your health care provider
Call 911 or a local crisis line immediately if you are having suicidal thoughts.

Call for an appointment with your health care provider if:
    Symptoms do not improve with self-treatment
    Symptoms interfere with your daily life

References

    Vigod SN. Understanding and treating premenstrual dysphoric disorder: an update for the women's health practitioner. Obstet Gynecol Clin North Am. 2009;36:907-924, xii. [PubMed]
    Lentz GM. Primary and secondary dysmenorrhea, premenstrual syndrome, and premenstrual dysphoric disorder: etiology, diagnosis, management. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 36.

    Review Date: 12/22/2010.

    Reviewed by: Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.